四肢长骨内生软骨瘤及软骨肉瘤的影像分析

The imaging findings of chondroma and chondrosarcoma in long bone of limbs

目的探讨四肢长骨内生软骨瘤及软骨肉瘤的影像学表现。方法回顾性分析经病理证实的6例四肢长骨内生软骨瘤和2例软骨肉瘤的X线平片、CT及MRI的影像学特征。结果 6例内生软骨瘤中,肱骨近侧及股骨远侧干骺端各2例,胫骨及腓骨骨干各1例。2例软骨肉瘤中,股骨骨干1例,腓骨小头1例。7例病变在X线及CT上呈现沙砾状、逗点状及环状钙化,1例骨皮质内缘可见扇贝样压迹。80例患者MRI检查在脂肪抑制序列T2WI呈明亮的高信号。除1例腓骨小头软骨肉瘤及1例腓骨骨干内生软骨瘤外,所有病例均未见明显膨胀性改变。结论沙砾状、逗点状及环状钙化和骨皮质内缘扇贝样压迹以及T2WI呈明亮高信号可作为四肢长骨内生软骨瘤及软骨肉瘤的重要诊断依据。对于老年患者应警惕软骨肉瘤可能。

Objective To analyze the imaging features of chondroma and chondrosarcoma in long bone of limbs. Methods Conventional radiographs, CT and MRI manifesitations of 4 patients with chondroma and 2 patients with chondrosareoma in long bone of limbs confirmed by pathology were retrospectively analyzed. Results Chondroma：2 case in humerus metaphysis,2 case in femur metaphysis, 1 case in tibial diaphysis, 1 case in fibula diaphysis. Chondrosarcoma： 1 case in femur diaphysis, 1 case in fibula head. The imaging appearance of 7 case on the conventional radiographs and CT was calcification liking grit, comma and ring. Bone cortex of 1 case is visible around the shell impression. The bright signal intensity on T2WI with fat suppression of MRI was found. All were no expansion excluded fibulae capitulum and fibula diaphysis. Conclusions The calcification liking grit, comma and ring, shell impression around the cortical bone margin and the bright signal intensity on T2WI are important diagnostic foundations of ehondroma and chondrosarcoma in long bone of limbs. The probability of chondrosarcoma should be alerted to elder patients.